Measles – and Vaccines – A Timely Topic of Interest in Our Community

MeaslesMeasles. A highly contagious and potentially severe and even deadly disease that causes fever, rash, cough, and red, watery eyes and spreads very easily by air and by direct contact with an infected person, has now been reported in Orange County.  There is a real cause for concern for those not immunized against the disease.

Dr. Dean Blumberg, Chief of Pediatric Infectious Diseases at UC Davis Children’s Hospital in Sacramento shares great concern over the spread of Measles. He shares that “The measles, we know, used to kill hundreds of thousands of children every year,” that “Measles is one of the most infectious diseases known to mankind” and “when [Measles] gets into a susceptible population, 90 percent of people end up being affected with it.”

Why has the disease been getting a lot of press lately? Because although it had been all but eradicated in 2000 due to successful prevention efforts, it has been spreading across the United States at an increasing rate over the past few years. In 2018, 371 cases of measles were confirmed in the United States. In the first four months of 2019, 681 people in 22 states have already had a confirmed case of measles. This year, a state of emergency was declared in New York City and Washington in response to the extremely contagious disease. The Center for Disease Control states this is the highest outbreak of the disease in 20 years.

What has caused the disease to return to the United States after having been deemed eradicated?  The World Health Organization, National Institute of Health, and the Centers for Disease Control attribute the resurgence to the anti-vaccination movement and parents refusing to immunize their children. This, combined with international travel by United States Citizens and foreign travelers coming into the United States, has allowed the exposure to the Measles to infect unvaccinated individuals.  Because there was an exemption to the vaccination requirement for those who expressed a personal or religious belief against vaccination, there remained, and still remains, a large population vulnerable to infection of the Measles virus.

In 2015, SB 277 was initiated to eliminate the vaccination exemptions in California. The authority of the legislature to require school immunizations without regard to personal and religious beliefs was held valid based on the U.S. Supreme Court Case Zucht v. King (1922) and Prince v. Massachusetts (1944).  The bill passed. But while the personal and religious belief exemption from vaccinations (including the Measles vaccination) was primarily eliminated in California by SB 277, limited exceptions remained for those who filed a notice of belief prior to the commencement of the bills effective date, July 1, 2016.  See SB 277 and Cal. Ed. Code 48216(1)(g) and 48216(2). Those individuals remain unprotected by the MMR vaccine.  The exemption from vaccination for medical reasons provided by a physician remain in effect. However, as of July 1, 2019, the basis for the exemptions must be specifically stated by the physician. See Cal Ed Code Section 48216 (c).

Measles can be prevented. The prevention is the MMR vaccine.  However, because a portion of the populations remains anti-vaccination, there remains a risk the Measles virus will infect those not vaccinated.  And the risk of being infected by the Measles virus to Orange County residents who have not been vaccinated against the virus is real, and imminent. Just last week, and Orange County woman returned from foreign travel infected with the Measles virus. She then visited areas in Santa Ana and Fullerton before being  diagnosed with the disease. Anyone who came into contact with her in the past few weeks could have been exposed to the highly infectious disease. Residents with questions about the measles are encouraged to call the HCA’s health referral line at 800-564-8448.

Because the Measles is extremely contagious and is potentially fatal for children, it remains one of the vaccines mandated by the United States Government to allow enrollment in any public or private educational institution.  California follows the federal guidelines in requiring children grade Kindergarten through 12th grade to obtain vaccinations prior to being permitted to attend public or private school.  

Currently, every student seeking a public or private education in California must be vaccinated. Starting July 1, 2019, those vaccinations each student, admitted to pre-K and Kindergarten through 12th grade are:

  • Diphtheria, Tetanus, and Pertussis (DTaP, DTP, Tdap, or T d) — 5 doses 
    (4 doses OK if one was given on or after 4th birthday. 3 doses OK if one was given on or after 7th birthday.)
    For 7th-12th graders, at least 1 dose of pertussis-containing vaccine is required on or after 7th birthday. 
  • Polio (OPV or IPV) — 4 doses 
    (3 doses OK if one was given on or after 4th birthday) 
  • Hepatitis B — 3 doses 
    (not required for 7th grade entry) 
  • Measles, Mumps, and Rubella (MMR) — 2 doses 
    (Both given on or after 1st birthday) 
  • Varicella (Chickenpox) — 2 doses 

These immunization requirements also a`pply to students entering transitional kindergarten.  See Cal Health & Safety Code Section 120325.

Regardless of your personal or religious beliefs regarding vaccinations, it is important that this outbreak of the Measles be taken seriously. If you believe you have been infected by Measles,  please quarantine yourself to prevent further spread, notify your local hospital and the CDS immediately. 

For those parents enrolling their children in public or private school, please check your immunization records and ensure you are up-to-date. If you are not, contact your physician and schedule an appointment to update your child’s immunizations.

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